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General NPI Number Information
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NPI Number | 1457791154
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Entity Type | Individual
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Provider Name | JENNA EMERSON MD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 265 N BROADWAY
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City | PORTLAND
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State | OR
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Zip | 97227-1800
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Country | US
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Telephone | 503-280-1223
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Fax |
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Provider Business Mailing Address
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Address Line | 1498 SE TECH CENTER PL STE 240
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City | VANCOUVER
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State | WA
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Zip | 98683-5508
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD197593
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | MD197593
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License Number State | OR
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